Brief report: clonazepam behavioral side effects with an individual with mental retardation.

Behavioral side effects associated with clonazepam may include agitation, aggression, hyperactivity, irritability, property destruction, and temper tantrums. These side effects may be inadvertently confused with other behavioral or psychiatric conditions, especially if exacerbation of existing challenging behavior occurs. This report describes an individual with mental retardation who experienced behavioral exacerbation associated with clonazepam prescribed at 2 mg/day (0.02 mg/kg/day) to treat aggression, self-injurious behavior, property destruction, and screaming, which was measured with a 15-minute partial interval recording measurement method. When clonazepam was reduced and discontinued, these behaviors significantly decreased from 3.1% of intervals (95% confidence band = 1.6% to 4.6%) to 0.1% of intervals (95% confidence band = 0% to 0.1%). Indicators suggesting review by appropriate medical personnel for possible clonazepam behavioral side effects are provided.

Benzodiazepine behavioral side effects: review and implications for individuals with mental retardation.

Behavioral side effects associated with benzodiazepines (such as clonazepam, diazepam, and lorazepam) are an easily overlooked and underrecognized problem with individuals who have mental retardation and can be inadvertently confused with other behavioral or psychiatric conditions. Based upon a literature review, behavioral side effects occurred for 13.0% of 446 individuals with mental retardation who were prescribed benzodiazepines for either behavioral or psychiatric conditions (n = 138, 17.4%), epilepsy (n = 208, 15.4%), or other medical conditions such as myoclonus or cerebral palsy (n = 100, 2.0%). Behavioral side effects for individual benzodiazepines for which data were available ranged from 11.4% to 25.0%. Implications of nonrecognition are discussed, and clinical indicators suggesting review by appropriate medical personnel are provided.